Running on Empty: Adrenal Fatigue

Three years ago, it seemed like I was always seeing my sports chiropractor for two recurrent injuries: a persistent tightness (and pain) in my left knee as well as my lower back. At the time, I worked out about two hours on most days, often doing long runs on the same day as intense strength training.  (I knew better but couldn’t seem to stop myself.)

“Tightness in the lower back and left knee is usually indicative of adrenal fatigue,” my chiropractor told me.  A marathon runner and triathlete, himself, he warned me of the perils of overtraining and recommended that I alternate cardio and weight-training and cut my workout time—by half.  I blithely ignored his well-intended advice.

But, this year, I experienced a full-blown adrenal exhaustion that was impossible to ignore.

My symptoms manifested as chronic upper respiratory infections; recurrent viral infections; severe allergies; hypersensitivity to sound and smell; loss of physical stamina; flat mood; and low thyroid. In February, I knew something was inherently wrong when my biggest challenge was getting out of bed in the morning (even after eight-plus hours of sleep); then, if I managed to do so, I moved through my day as though drugged.  The simple act of sitting in front of my laptop triggered anxiety and left me perspiring.  Even a short telephone conversation was physically draining. Going to bed bound tighter than a mummy, in layers of long underwear and two wool sweaters for warmth—yes, I was that cold!—wasn’t fun either.  And, for the first time in my life, I had absolutely zero desire to exercise.

I sought help, but conventional doctors didn’t seem to have any insight—or solutions, other than offering a prescription for an antibiotic; a steroid inhaler or oral medication for my allergies; or generic counsel along the lines of “Reduce your stress!”or “Take it easy!” before telling me to “check back in six months so we can ‘monitor’ your situation.”

I finally found an integrative doctor who asked all the right questions.  He ran extensive tests, which revealed that my cortisol was very low, indicative of low adrenal function.  I also had low thyroid, which frequently accompanies adrenal fatigue.  By this time, my other hormones were out of whack, and he warned me that it would be at least a year before I would feel any significant improvement.

Your two grape-sized adrenal glands—each one sits on top of a kidney—produce cortisol (a.k.a. the “’fight-or-flight’ stress hormone”) and the stress neurotransmitters epinephrine (adrenaline) and norepinephrine.  Cortisol raises blood sugar and increases blood pressure.  It also regulates your immune system, and when your immune system is healthy, cortisol helps reduce inflammation. Depending on what stage of adrenal dysfunction you are experiencing, your cortisol levels can be either too high or too low.  Chronically elevated cortisol levels suppresses the immune system, leaving you vulnerable to viruses and bacterial infections. Chronically low levels of cortisol leads to an overactive immune system, creating inflammation that may manifest as food sensitivities, autoimmune diseases (eg, Hashimoto’s thyroiditis), mood disorders and body pains and aches.

The adrenal glands also serve as a secondary source of sex hormones for both men and women.

Adrenal fatigue is all too common in our modern, multi-tasking, over-scheduled culture, where 24/7 accessibility (to products, services and people) is the norm.  Yet, conventional medicine does not recognize or treat adrenal fatigue unless you have Addison’s Disease (adrenal failure or adrenal insufficiency), a rare autoimmune disease from which President John F. Kennedy suffered.  Treatment protocol for Addison’s usually requires lifelong corticosteroid replacement therapy.

Adrenal fatigue can be mild (and temporary), like the college student who pulls an all-nighter.  But if burning the candle at both ends becomes a perpetual way of life, cortisol levels will be continuously high. And, as we know…what goes up must come down.  Eventually, as your adrenal glands falter, unable to keep up with a constant demand for cortisol, your cortisol will become persistently low.  At this point, you enter a more severe and debilitating late stage of stress—adrenal exhaustion.  The onset of adrenal fatigue can be gradual or triggered by a single traumatic event, such as a major surgery, toxic exposure or life crisis. Adrenal fatigue is democratic—anyone can experience it: a student, teacher, CEO, caregiver, mothers, even children.

Like a master conductor, the adrenal glands mobilize your body’s responses to stress—through hormones that maintain energy production, immune function, heart rate, muscle tone and other stress-coping mechanisms. The type of stress you experience can be emotional (eg, grieving the death of a loved one); physical (eg, over-exercising, illness, exposure to environmental toxins); or psychological (a hostile work environment, being in an abusive relationship).  Caregivers are especially susceptible to adrenal fatigue.  With little time to themselves and often having to divide their time between work, family, friends, spouse and care-giving, caregivers—whether caring for aging parents, someone with a disability, disease or Alzheimer’s—are at higher risk for physical health problems, as well as anxiety and depression.

Depending on your stage of adrenal fatigue (early or advanced), you can experience a collection of symptoms of varying intensity, including (but not limited to) high blood pressure, cravings for sugar or caffeine, electrolyte imbalance, light-headedness, fuzzy thinking, chronic fatigue, low blood pressure, lethargy, feeling overwhelmed, mild depression, difficulty getting out of bed in the morning, lethargy, strong cravings for salt and multiple chemical sensitivities.

In retrospect, I realize that I have had varying degrees of adrenal fatigue over the last five years.  The transition to adrenal exhaustion began in early 2012—a year already fraught with professional and personal changes—when I came down with four consecutive upper respiratory infections over five months—each lingering longer than the last. Ultimately, this led to imbalances in mood and gut flora, mineral depletion, digestive distress and hormonal imbalance.  At the end of last year, I was prescribed two separate courses of antibiotics, taken a month apart, further undermining my gut health and, consequently, my immune system.  In my case, chronically elevated levels of cortisol resulted in my experiencing recurrent bouts of bronchitis, asthma, sinusitis or other respiratory infections.  From an integrative health and functional medicine perspective, chronic infections are one of the most commonly overlooked sources of stress and resistant adrenal fatigue.

There is, however, a gift in every health challenge. My body gave me no choice but to slow the pace of my life from a sprint to a crawl—no easy task for an obsessive-compulsive Type A perfectionist (and workaholic).  It’s especially challenging in New York City, where taking yourself out of the fast lane can feel like career suicide. The upside?  I’ve learned life lessons that I would not have otherwise.  Like, making peace with being less than “perfect”.  Saying “no” becomes easier when you have little energy, as does focusing on what—and who—really matters. Most importantly, I’ve learned that recovering from adrenal fatigue is a holistic process: it takes more than an Rx for thyroid hormone or adrenal support to “snap out” of a depleted state.

Here’s the good news: with dietary and lifestyle changes, you can recover from adrenal fatigue, including later-stage adrenal exhaustion.  However, self-care must be a non-negotiable priority—it’s not a sign of weakness.

In the last eight months, I’ve made progress from what felt like Ground Zero—unrelenting chronic fatigue, zero tolerance for exercise (even walking) and limited social contact—to a place where I have more energy and cautious optimism.

Stayed tuned for my next post on recovering from adrenal fatigue….I’ll be sharing my journey.

 

Photo Credit: Badr Safadi